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Cardiovascular Physiology Elsevier eBook on VitalSource (Retail Access Card), 10th Edition

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Elsevier eBook on VitalSource - Access Card®

Cardiovascular Physiology Elsevier eBook on VitalSource (Retail Access Card), 10th Edition

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Cardiovascular Physiology gives you a solid understanding of how the cardiovascular system functions in both health and disease. Ideal for your systems-based curriculum, this title in the Mosby Physiology Monograph Series explains how the latest concepts apply to real-life clinical situations.

  • Get clear, accurate, and up-to-the-minute coverage of the physiology of the cardiovascular system.
    • Master the material easily with objectives at the start of each chapter; self-study questions, summaries, and key words and concepts; and a multiple-choice review exam to help prep for USMLEs.
    • Grasp the latest concepts in vascular, molecular, and cellular biology as they apply to cardiovascular function, thanks to molecular commentaries in each chapter.
    • Apply information to clinical situations with the aid of clinical commentaries and highlighted clinical vignettes throughout.
    • Access the fully searchable text and downloadable images online at www.studentconsult.com!

    vii

    CON T E N T S

    C H A P T E R 1

    OVERVIEW OF THE CIRCULATION

    AND BLOOD 1

    The Circulatory System 1

    Blood 5

    Erythrocytes 5

    Leukocytes 6

    Lymphocytes 7

    Blood Is Divided into Groups by Antigens

    Located on Erythrocytes 7

    Summary 9

    Case 1-1 9

    C H A P T E R 2

    EXCITATION: THE CARDIAC

    ACTION POTENTIAL . 11

    Cardiac Action Potentials Consist of Several

    Phases 11

    The Principal Types of Cardiac Action

    Potentials Are the Slow and Fast

    Types 12

    Ionic Basis of the Resting

    Potential 13

    The Fast Response Depends Mainly on

    Voltage-Dependent Sodium

    Channels 15

    Ionic Basis of the Slow Response 24

    Conduction in Cardiac Fibers Depends on

    Local Circuit Currents 25

    Conduction of the Fast Response 25

    Conduction of the Slow Response 27

    Cardiac Excitability Depends on the

    Activation and Inactivation of Specific

    Currents 27

    Fast Response 27

    Slow Response 28

    Effects of Cycle Length 28

    Summary 29

    Case 2-1 29

    C H A P T E R 3

    AUTOMATICITY: NATURAL

    EXCITATION OF THE HEART . 31

    The Heart Generates Its Own Pacemaking

    Activity 31

    Sinoatrial Node 32

    Ionic Basis of Automaticity 34

    Overdrive Suppression 35

    Atrial Conduction 36

    Atrioventricular Conduction 37

    Ventricular Conduction 39

    An Impulse Can Travel Around a Reentry

    Loop 41

    Afterdepolarizations Lead to Triggered

    Activity 42

    Early Afterdepolarizations 43

    Delayed Afterdepolarizations 43

    Electrocardiography Displays the Spread of

    Cardiac Excitation 44

    Scalar Electrocardiography 44

    Dysrhythmias Occur Frequently and

    Constitute Important Clinical

    Problems 47

    Altered Sinoatrial Rhythms 47

    Atrioventricular Transmission Blocks 48

    Premature Depolarizations 48

    Ectopic Tachycardias 49

    Fibrillation 49

    Summary 51

    Case 3-3 52

    C H A P T E R 4

    THE CARDIAC PUMP 55

    The Gross and Microscopic Structures of the

    Heart Are Uniquely Designed for Optimal

    Function 55

    The Myocardial Cell 55

    Structure of the Heart: Atria, Ventricles,

    and Valves 60

    The Force of Cardiac Contraction Is

    Determined by Excitation-Contraction

    Coupling and the Initial Sarcomere Length

    of the Myocardial Cells 63

    Excitation-Contraction Coupling Is

    Mediated by Calcium 63

    Mechanics of Cardiac Muscle 65

    The Sequential Contraction and Relaxation of

    the Atria and Ventricles Constitute the

    Cardiac Cycle 69

    Ventricular Systole 70

    Echocardiography Reveals Movement of

    the Ventricular Walls and of the

    Valves 73

    The Two Major Heart Sounds Are

    Produced Mainly by Closure of the

    Cardiac Valves 74

    The Pressure-Volume Relationships in the

    Intact Heart 75

    Passive or Diastolic Pressure-Volume

    Relationship 75

    Active or End-Systolic Pressure-Volume

    Relationship 77

    Pressure and Volume during the Cardiac

    Cycle: The P-V Loop 77

    Preload and Afterload during the Cardiac

    Cycle 77

    Contractility 78

    The Fick Principle Is Used to Determine

    Cardiac Output 79

    Summary 89

    Case 4-1 90

    C H A P T E R 5

    REGULATION OF THE

    HEARTBEAT 91

    Heart Rate is Controlled Mainly by the

    Autonomic Nerves 91

    Parasympathetic Pathways 92

    Sympathetic Pathways 93

    Higher Centers Also Influence Cardiac

    Performance 97

    Heart Rate Can Be Regulated via the

    Baroreceptor Reflex

    Achilles J. Pappano, PhD, Professor; Department of Pharmacology and Calhoun Cardiology Center; University of Connecticut Health Center; Farmington, CT and Withrow Gil Wier, PhD, Professor, University of MD Baltimore, Dept. of Physiology, Baltimore, Maryland
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